P1592: MATCHED CONTROL COMPARISON OF SURVIVAL OF HOSPITALIZED COVID-19 PATIENTS WITH HEMATOLOGICAL MALIGNANCIES, DATA FROM A LARGE TERTIARY CENTER REGISTRY
Authors: M. Lucijanic, E. Soric, M. Sedinic, A. Sabljic, S. Tomasinec, A. Pasaric, M. Ivic, T. Vasilj, D. Cicic, Z. Jonjic, M. Pirsic, Z. Mitrovic, Z. Prka, V. Pejsa, R. Kusec, O. Jaksic
Journal: HemaSphere (2022)

Background: There is an increasing pool of evidence describing detrimental outcomes of patients with hematological malignancies with acute COVID-19. Aims: to evaluate risk of death with acute COVID-19 in patients with various hematological malignancies in comparison to matched control patients from a large single institution registry. Methods: We retrospectively analyzed all consecutive hospitalized COVID-19 patients treated in period 3/2020-3/2021 in our institution (University hospital Dubrava) that served as a regional COVID-19 referral center during the pandemic. Data from a hospital Registry project were used. Patients with hematological malignancies were compared to the case-control matched group of patients without malignant disease. Matching was performed according to age, sex and modified Charlson comorbidity index (with subtracting points provided for hematological malignancy in hematological malignancy patients). Results: Out of total 4014 consecutive hospitalized COVID-19 patients, there were 154 patients with hematological malignancies. There were 81/154 (52.6%) male patients. Median age was 71 years and median Charlson comorbidity index was 5 points. Most represented hematologic malignancy subtype was chronic lymphocytic leukemia (CLL) present in 37/154 (24%) patients, followed by aggressive lymphomas (30/154 (19.5%)), plasma cell dyscrasias (28/154 (18.2%)), acute leukemias (21/154 (13.6%)), indolent non Hodgkin lymphomas (18/154 (11.7%)), myelodysplastic syndromes (MDS, 12/154 (7.8%)) and chronic myeloproliferative leukemias (8/154 (5.2%)). Disease course significantly differed between disease subsets (P=0.004) as shown in Figure. Patients with CLL and indolent lymphomas experienced more favorable disease course comparable to matched control groups of COVID-19 patients without malignancies, whereas other subsets of patients experienced more rapid deterioration. Recent treatment (actual or in 3 months prior to admission) did not affect survival outcomes (P=0.402), as well as active disease status (P=0.076) but where tendency for worse survival was evident. Patients previously receiving autologous or allogeneic stem cell transplantation also did not significantly differ in survival in comparison to non-transplanted patients (P=0.425). In a multivariate survival analysis, acute leukemias (HR 5.88; P<0.001), MDS (HR 2.91; P=0.006), plasma cell dyscrasias (HR 4.68; P<0.001) and aggressive lymphomas (HR 2.53; P<0.001) were associated with worse survival in comparison to matched control patients independently of age (HR 1.04; P<0.001), modified Charlson comorbidity index (HR 1.1; P=0.017), and COVID-19 severity on admission (HR 5.98; P=0.003 for severe and HR 11.06; P<0.001 for critical vs mild disease). Image:Summary/Conclusion: Hospitalized COVID-19 patients with acute leukemias, MDS, plasma cell dyscrasias and aggressive lymphomas experience higher mortality irrespectively of age, comorbidity burden and COVID-19 severity on admission.